AN ESTIMATED 120,000 Rhode Islanders have no health coverage. Most of the uninsured are working people and their families. Low-income, hourly wage employees in the hospitality industry and their families alone number about 40,000, or nearly one-third of the uninsured population in Rhode Island. Employees of non-profit organizations, the construction industry and the fishing industry, along with those who work in small companies or are self-employed, often are uninsured. The number of uninsured continues to grow as the economic downturn results in layoffs and the loss of benefits.

The state’s budgetary deficit is forcing policy makers to make tough decisions. Thousands of RIte Care beneficiaries are slated to be dropped from the program this year because of budget shortfalls. The General Assembly is aggressively looking for ways to provide a safety net for the children and their parents who will lose their RIte Care coverage. While RIte Care clearly is the best option for this population, the budget crisis creates an opportunity for the General Assembly to strengthen our community health centers and the rest of the primary-care system in the state to be that safety net.

This could be accomplished through the creation of a voucher system similar to the one used by the Scituate Health Alliance. For about $300 to $400 a year, or $75 to $100 a quarter, individuals who have lost their RIte Care coverage could get their primary care from a community health center or a family practice that would be willing to accept a capitated payment.

Access to primary care is a critical factor in the health status of any population. Regular check-ups, flu shots and other inoculations, and being able to see one’s own physician when one is sick, can significantly reduce the unnecessary use of emergency rooms and other expensive health-care services. Management of chronic diseases and ensuring compliance with prescription-medication regimens also can help reduce unnecessary hospitalization.

With the launch of Health Access RI in January, there is an additional resource available to policy makers and employers, as well as individuals and their families. Health Access RI is composed of a number of family practitioners around the state prepared to provide extensive primary-care services to individuals and families for $25 to $30 a person a month. These services include routine check-ups, physicals, family planning, well-child care, chronic-disease management and emergency phone coverage. Health Access RI patients also receive significant discounts for lab work, X-ray and imaging services, physical therapy and prescription drugs.

Health Access RI is not health insurance; nor is it a substitute for comprehensive health coverage. It does not provide for hospital care or specialty-care services. Health Access RI is an affordable way for uninsured individuals and families to have their own personal family physician, who not only can provide most of the care that a patient needs but also will be an active partner in keeping that patient healthy. And when Health Access RI patients are sick, they usually are seen by their own physician the same day.

Health Access RI is an inexpensive way for employers to recruit and retain valuable employees, and to keep those employees and their families healthy. It may also be an affordable alternative for those individuals who lose their RIte Care benefits. When both employer-sponsored health care and state-funded health services face dramatic cuts, it is vital that all Rhode Islanders have access to primary care. A strong primary-care infrastructure in Rhode Island will go a long way towards keeping our population healthy and reducing unnecessary health expenditures. Health Access RI is the first step in creating that infrastructure.

Michael Fine, M.D., is a primary-care physician and Rhode Island state Sen. Stephen Alves, of West Warwick, is chairman of the Senate Finance Committee.